The France-based medical aid group Doctors Without Borders (MSF) announced it was leaving Somalia after 22 years due to security concerns. The organization that provides crucial health relief in conflict settings has remained in Somalia through some of the most violent stretches. The announcement comes as a surprise and a signal that Somalia’s improvements may be more tenuous than previously reported.
Two MSF staff were killed in December of 2011 while working on Somalia’s capital city of Mogadishu. Another pair of staff were released last month after being held for 21 months in south central Somalia after they were kidnapped from Kenya’s Dadaab refugee camp. MSF says the two incidents highlight only a part of the challenges it has faced in Somalia since 1991. Attacks on MSF staff, ambulances and medical clinics have led to an additional 14 deaths.
Medical programs in Mogadishu, its suburbs and in other parts of Somalia will be closed. MSF says its 1,500 strong staff provided more than 624,000 medical consultations, admitted 41,100 patients to hospitals, cared for 30,090 malnourished children, vaccinated 58,620 people, and delivered 7,300 babies in 2012. The cessation of MSF’s work in Somalia will have an immediate impact on Somalis.
“Ultimately, civilians in Somalia will pay the highest cost,” said Dr. Karunakara. “Much of the Somali population has never known the country without war or famine. Already receiving far less assistance than is needed, the armed groups’ targeting of humanitarian aid and civilians leaders’ tolerance of these abuses has effectively taken away what little access to medical care is available to the Somali people.”
MSF’s work in Somalia dates back to the beginning of the ongoing civil war. The worsening humanitarian situation led to the deployment of a UN peacekeeping force and security force to ensure the delivery of essential humanitarian supplies. The force had the greenlight to engage in fighting if necessary with the peak incident being the failed attempt by US troops to capture United Somali Congress commander General Mohamed Farah Aidid. The event was dramatized by the film Black Hawk Down.
As the fighting continued MSF remained and stayed through the 2011 famine and as the country has slowly begun to stabilize. Recent reporting has focused on the general return to normalcy within Mogadishu to show that the country may be finally emerging from the decades of fighting and moving forward. AU forces have been successful in expanding the control of the Somali government by fight back the al Shabaab Islamist rebels. Somalia held elections following the 2011 ouster of al Shabaab from Mogadishu, but fighting continues on the Shabaab-controlled south.
It appears that dangers faced by aid workers are making it hard for agencies like MSF. The group says Somalia is the only country where it has to employ armed guards to protect its staff who are already severely limited to where they can work. MSF says it remains committed to providing humanitarian assistance, but needs Somalia to ensure the safety of its workers.
“In choosing to kill, attack, and abduct humanitarian aid workers, these armed groups, and the civilian authorities who tolerate their actions, have sealed the fate of countless lives in Somalia,” said Dr. Unni Karunakara, MSF’s international president. “We are ending our programmes in Somalia because the situation in the country has created an untenable imbalance between the risks and compromises our staff must make, and our ability to provide assistance to the Somali people.”
The decision comes at a time when polio made a return to Somalia. More than 100 cases of polio were recorded in Kenya and Somalia between May and July of this year, says the WHO. There were only 250 cases of polio in 2012, globally.
“There is a very real risk that this outbreak could quickly become a problem across the entire region. We must act now to stop this deadly and debilitating disease from spreading further,” said UK International Development Secretary Justine Greening earlier this month.
The UK and others are acting quickly to prevent the spread of polio in Kenya and Somalia. Losing hundreds of medical aid workers due to the MSF pull out will have a negative impact on the response.